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Guest opinion: A vote for Obama saves real healthcare reform

By Brad D. Segal

Posted:
10/19/2012 01:00:00 AM MDT

In the Oct. 3 presidential debate Mitt Romney said that, if elected, he intends to "repeal and replace" the Affordable Care Act (ACA). He also told us not to worry, because under Romney/Ryan, pre-existing conditions would be covered, just as with the ACA. Don't believe him. Like many of his other debate claims, this claim isn't true.

Actually, under his plan, Americans with pre-existing conditions would remain uninsurable if they have not maintained "continuous insurance coverage" (this includes millions who have been uninsured through no fault of their own). Unfortunately this is just one of many important health reforms we probably lose if Romney becomes president. We may also lose Medicare and Medicaid as we know them if he is elected.

What is the problem that ACA addresses, and why do we need this particular reform versus some Republican version anyway?

America has had an unsustainable health system. We spend roughly twice as much per-- capita as the rest of the developed world ---- $2.6 trillion in 2010 -- yet are ranked 37th in health outcomes by the World Health Organization. Add to this 22,000 deaths and 700,000 bankruptcies in a typical recent year due to gaping holes in health coverage -- outcomes not found in any other of the world's developed nations.

ACA goes after these excessive costs, inefficiencies and inequities using common sense principles found in sustainable health systems around the world, namely:

ACA addresses each of these. It insures an additional 32 million people: a substantial move toward universal coverage. It guarantees coverage unconditionally, and incorporates cost controls, including rebates for insurance overcharges. The act prohibits lifetime coverage limits. It allows young adults to remain on their parent's policy until age 26.

What would Romney/Ryan offer? Not much:

1) A very limited version of pre-existing condition coverage, leaving out millions for life.

2) A vague promise to allow young adults to remain on their parent's policy.

Romney/Ryan would also leave 50 millions Americans uninsured, including a growing pool of millions of permanently uninsurable people. Medical--related bankruptcies would continue, largely unabated, contributing to overall economic instability. Further elevation of rates would likely result from lack of cost-controls on insurers.

Why can't Romney/Ryan offer truly comprehensive coverage for pre-existing conditions, as ACA does? Answer: Ryan/Romney doesn't have any leverage to accomplish this because, unlike ACA, it lacks an individual mandate. By requiring coverage for everyone, including millions of healthy customers, this mandate allows insurers to recoup the cost of also having to cover the highest risk individuals. It's simple economics -- insurers must balance risks or go broke.

Romney/Ryan would only work if had an individual mandate (as in Massachusetts) making it much more like ACA. My point: there is no reason to replace ACA -- because it works. Though far from perfect, ACA does improve what has been a fundamentally broken system.

Being the smart man that he is, and given his success with essentially an ACA " clone" in Massachusetts, I believe that Romney knows this, but is derailing what might be the best next step toward saving America's health system and economy simply to placate his right-wing base. He is simultaneously trying to portray himself as not really that extreme, using misinformation to deceive undecided voters.

Unfortunately misinformation seems to be a recurring Romney theme. He's a flip-flopper trying to create the impression that you can have it both ways. Once he's president, however, and has to make real decisions, that won't be possible.

Undecided voters: don't be fooled by Romney's tricks. Obama's overall plan is working. Having already saved us from a depression, it is slowly but surely pulling us out of the morass left by 8 years of failed Republican leadership. His approach is working, incorporating reasonable health reform and a sensible economic plan that may well help prevent the next collapse. Republicans are offering simply "more of the same" with fancier packaging. Their health "plans" are just one example. Please join me in supporting President Obama. Let's finish the job.

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